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(en) France, Alternating Current* #215 - Refuse the application of the new law on psychiatry! [machine translation]

Date Fri, 30 Dec 2011 19:08:53 +0200

Since August 1, the Act of July 5, 2011 on "the rights and the protection of persons under psychiatric care ... "Entered into force. The security logic that underlies this legislation is the confusion between mental illness and dangerousness. The "forced care program," introduced unlimited control patients, in line with security policies. The procedures for admission to hospital are facilitated and constrained the powers of the prefect strengthened. ---- Routine monitoring by the courts and detention (JLD) for all patients hospitalized for more than 15 days, against his will, however, is a real breakthrough. The psychiatrist, the director, the prefect now share the responsibility to decide on a deprivation of liberty to force to care. The patient is (finally) a person who has rights, including the right not to be deprived of liberty a simple administrative decision as was the case in the law of 90. However, the judges have to make thousands of decisions, did not receive additional resources.

Care procedures STRESS

Far in France, there were two main types of investment in hospital: the hospital and the stress free, at the request of either third or the prefect or mayor. Now it is the care that may be required. In the case of such decisions without consent, the judge must now give its approval within two weeks, and repeat every six months. The law creates a new hospitalization for imminent danger, signed by the director of the hospital. (See box)


A psychiatrist, a member of the multidisciplinary team involved in the care of the patient and a psychiatrist not participating, form this college, whose opinion is required for the release request of some patients' potentially dangerous suspects. " In these cases, the two expert ordered by the prefect must be consistent with the opinion of the medical college for the decision to be taken by show of hands.

Creating a new category of patients on their own supposedly dangerous history, with formation of a computer file. This arrangement offers the prospect of a widespread national FILING any person receiving specialized care. It is the confusion between "madness" and "dangerousness" thus justifying the introduction of a politics of fear, a society under surveillance.

PROGRAM "CARE ... Constraint ": an invasion of personal privacy which is not limited in duration. Coercion and social control are erected as organization models CARE
Any entry in the "forced care" begins with a hospital stay of 72 hours. After this period, the doctors propose to the Director or the Prefect for the SDRE, the form of support: removal of any form of interference, continued full hospitalization or "forced outpatient program." Y are defined, the modalities of care imposed their venues (part-time hospitalization, consultations, home visits) and frequency. If the patient is "honoring" of its obligations, the psychiatrist shall inform the Director, if the prefect, and offers a complete re-hospitalization.

This program of "forced treatment" does not impose a continuing hospitalization, is not subject to the judge of freedoms and detention. And a "care plan" in place before the expiry of fifteen days of full hospitalization, which would include one hour per day out, is not considered a deprivation of liberty sufficient to require control by the JLD!

Because it is a deprivation of liberty, the law is clear: the patient must be brought before the JLD before expiration of fifteen days. The JLD does not here to judge the guilt of a person, it acts as a third party guarantor of freedom of the person. He does not judge, the "madness" of a person make an order to maintain or discharge of a procÃdurede deprivation of liberty. The JLD, given two medical checks if the hospital continues is still needed. In case of extension of stay, referral automatic JLD is again at 6 months, one year, etc ...

Knowing that this device is heavy, the legislature allows video conferencing and the so-called fair justice, that is to say, the JLD moving to the hospital. "Can you imagine a big delusional be filmed on camera and talk," protested the Collective of 39 against the night safe. "We are fundamentally against the videoconference" announces the union of the judiciary. All hearings are public. Breaks of confidentiality publicize the suffering of those already vulnerable. Oddly, the council of the Medical Association is silent face of this unprecedented violation.

This act takes on a real headache for those who must implement it
since August, inflation daily administrative procedures (nearly 30 types of medical certificates to write now depending on the situation of hospitalization) serve the time and means actual care provided to hospitalized patients and followed as an outpatient.

Resist, disobey not to become police auxiliaries
degradation continues in psychiatry means that today an increasing number of people with mental health problems can be found on the streets without care, ends up in prison without even knowing why sometimes , and a greatly reduced life expectancy compared to the rest of the population. The Act of July 5 does not respect the law, particularly civil liberties and privacy of private life. Psychiatrists, Psychological Medical Centres have already announced they will not enforce the law, but the field strength is difficult to organize.

For health personnel, this should be an opportunity to contrast their caring role to that of auxiliary police, or social control, to claim the staffing and training sacrificed for twenty years at the expense of care and conditions work to prepare for the fight against mental health plan announced by the government. Health care teams, psychiatrists and paramedical managers may refuse prefects and the information needed pointing of a "sick alleged unsafe", but to inform people in hospital, so they do not fall into the trap that this law holds psychiatric but access to mental health care they are entitled to (and including the right to be assisted by a lawyer).


The law provides four methods of entry to the hospital in the absence of consent:
Care of the request of one third (SDT): 2 medical certificates other than by a psychiatrist working in the establishment of Home, a third request, the Director's decision. Care of the request of one third in Emergency (ETDS) : a single certificate, if issued by a psychiatrist practicing in the facility, the request for a third, the Director's decision. Care of imminent danger (SPI) : A single certificate from a psychiatrist who does not in the institution, lack of third Director's decision. Care of the decision of a representative the State (SDRE) : Only one medical certificate from a physician not engaged in the host institution (public awareness has been removed), decision of the prefect, the mayor or police commissioner in Paris. For the latter, the name of "requirements for the safety of persons and public order", the prefect may decide to change the shape of the management of the patient. It can also maintain a hospital despite the request of hands by the psychiatrist and the director. In this case it is the referee that the disagreement JLD Reeve / psychiatrist. Referral to the Judge of liberty and detention is made ââby the Director for the SDT, ETDS and SPI, and the prefect for the SDRE.

Follow one another slips since August 1, the date of application to the treatment without consent in psychiatry as "Mediapart, Tales of Ordinary Madness." Police operations to force patients to go to the hospital or, conversely, denial of hospitalization for people in very big trouble. This is a fully packed and activated seems absurd, to the detriment of patients.
A mother has a complaint against the operation of "medical police" that her daughter has suffered with schizophrenia. This young woman of 27 years, within the scope of a duty of care, the hospital has warned that it happened, to a depot injection. On his arrival at the station, the train was blocked by a team of 10 people including police officers, nurses, ambulance to take him by force to the hospital. The mother of the young woman does not dispute the need for hospitalization for his daughter, but can not accept the method used, totally disproportionate and traumatic for it.
In Lyon, a street was blocked by an impressive number of police helmets to "seek" a patient who did not open his door.
In Marseille, Serge Partouche, an autistic 48 year old died Wednesday, September 21, face down, face bloody, handcuffed by three police officers including one to knees on his back. The police had been called by a neighbor in conflict with parents. Serge had never been violent or threatening.
In contrast, Sept. 14, a mother lost her son who threw himself under a truck. An application for admission in the clinic had been denied a few days before the emergency department. The reason given by the ISSC (interassociative on Collective Health): depressives do not choose their hospital. The young man, an applicant for clinical management would not return to the hospital but had agreed to leave with medication. No order was given by the emergency physician.
* Monthly of Anarchist-Communist Libertar OCL
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